超声与导管法对比研究冠心病左室舒张功能  

Study of left ventricular diastolic function with echocardiography and coronary angiography

作　　者：吴长君[1] 赵鸿雁[1] 李玉丹[1] 

机构地区：[1]哈尔滨医科大学附属第一医院超声科,黑龙江哈尔滨150001

出　　处：《中国医学影像技术》2007年第8期1155-1157,共3页Chinese Journal of Medical Imaging Technology

基　　金：哈尔滨市培养学科后备带头人基金项目(2002AFXXJ056)资助。

摘　　要：目的探讨应用超声心动图测量舒张早期心室内充盈离散与心导管法对比评价左室舒张功能。方法连续观察262例患者,均行经胸多普勒超声检查和冠状动脉及左室造影检查。根据冠脉造影结果将患者分为冠脉正常组、冠脉基本正常组及冠脉异常组。超声心动图检查:心尖四腔切面将多普勒取样线置于二尖瓣口至心尖连线,分别将取样容积放置二尖瓣尖及距瓣尖1cm、2cm、3cm处连续获取脉冲多普勒频谱。分别测量二尖瓣尖舒张期血流峰值速度A0、E0及A0/E0比值,测量距瓣尖1cm、2cm、3cm舒张早期血流速度En(E1、2、3),计算En与E0比值。结果心导管检查中最大左室舒张速率、等容舒张时间常数,冠脉基本正常与冠脉正常组间不存在差异(P>0.05),冠脉异常组与冠脉正常组间存在差异(P<0.05);左室舒张末压、左室压力最大下降速率时对应左室压力、左房收缩前左室舒张速率各组间存在差异(P<0.05)。冠脉基本正常组及冠脉异常组左室舒张早期血流速度从二尖瓣口至心尖逐渐减低,舒张期心内充盈离散E3及E3/E0比值与E0及E1/E0比值存在差异(P<0.05)。结论左室内充盈离散度E3/E0可用于评价冠心病人左室舒张功能;冠脉异常组舒张早期弛张障碍重于冠脉基本正常者。　Objective To examine the left ventricular diastolic function of patients with coronary artery diseases by the intraventricular dispersion in peak early diastolic flow velocity and coronary angiography. Methods Mitral Doppler signals were recorded by the continuous wave Doppler technique in 262 patients, both coronary angiography and left ventricle pressure were measured. Patients were divided into normal, nearly normal and abnormal groups based on coronary angiography. Doppler echocardiography studies were obtained from mitral tip toward the apex （E0, E1, E2, and E3）： that is, mitral flow velocity （E0） and the intraventricular regional early diastolic flow velocity at 1 cm, 2 cm, 3 cm, from mitral tip toward the apex. Results Left ventricular end diastolic pressure （LVEDP）,the left ventricular negative Δp/Δt before atria contraction and left ventricular pressure derived from LV pressure dropped fastest in abnormal group were more than those in the normal and the nearly normal. Intraventricular dispersion of early diastolic filling were significantly lower in CAD subjects than those in healthy ones （P〈0.05）. The early regional peak diastolic flow velocity were progressively decreased from the tip toward the apex in patients with CAD. In early regional peak diastolic flow velocity, E3 and E3/E0 ratio were progressively and significantly lower than E0 and E1/E0 ratio （P〈0.05）. Conclusion The intraventricular dispersion of peak early diastolic flow velocity E3 and E3/E0 ratio may be useful in detecting LV early diastolic dysfunction in CAD. LV early diastolic dysfunction in abnormal groups were more severe than normal and nearly normal groups.

关 键 词：超声心动图 心导管 心室功能 左 

分 类 号：R541.4[医药卫生—心血管疾病] R540.45[医药卫生—内科学]